Considerations

Vaginal bleeding that occurs between periods or after menopause can be caused by various problems. Most are benign and treatable. Sometimes vaginal bleeding may be due to cancer or precancer. So any unusual bleeding should be evaluated promptly. The risk of cancer increases to about 10% in women with postmenopausal bleeding.

Make sure that bleeding is coming from the vagina and is not from the rectum or in the urine. Inserting a tampon into the vagina will confirm the vagina, cervix, or uterus as the source of bleeding.

A careful exam by your health care provider is frequently the best way to sort out the source of the bleeding. This exam can be accomplished even while you are bleeding. Do not delay getting an exam just because you are currently bleeding.

Cancer or precancer of the cervix, uterus, or (very rarely) fallopian tube

Cervical or endometrial biopsy or other procedures

Home Care

Immediately contact a health care provider if bleeding is very heavy.

Keep track of the number of pads or tampons used over time so that the amount of bleeding can be determined. Uterine blood loss can be estimated by keeping track of how frequently a pad or tampon is soaked and how often one needs to be changed.

Because aspirin may prolong bleeding, it should be avoided, if possible.

When to Contact a Medical Professional

Call your health care provider if:

You are pregnant

There is any unexplained bleeding between periods

There is any bleeding after menopause

There is heavy bleeding with periods

Abnormal bleeding is accompanied by other symptoms, such as pain, fatigue, dizziness

What to Expect at Your Office Visit

The doctor will perform a physical exam and ask questions about your medical history. The physical examination with include an emphasis on the pelvic area.

Questions may include:

Time pattern

When did this bleeding between periods begin?

Does it occur consistently, such as every month?

When (during the course of a menstrual cycle) does this bleeding begin?